SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I, ____________________________________, of legal age, single/married
and
a
resident
of
________________________________________________________________ do hereby
appoint, name and constitute ______________________________________ of legal
age,
single/married
and
a
resident
of
__________________________________________________________, to be my true and
lawful attorney-in-fact, to manage and conduct all my affairs and for that
purpose in my name and on behalf to do and executed all or any of the
following acts, deeds and things, to wit:
1. To

appear
on
my
behalf
____________________________________________________________________
____________________________________________________________________
_.

2. To

stand
on
my
behalf
____________________________________________________________________
____________________________________________________________________
_.

In general, to do all acts, deeds, matters and things whatsoever in or

about my estate, property and affairs or to concur with persons jointly
interested with myself therein doing all acts, deeds, matters and the things
herein, either particularly or generally described, as fully and effectually to
all intents and purposes as I could do in my own proper person if personally
present.
HEREBY GIVING AND GRANTING unto to my said attorney full power
and authority whatsoever requisite or necessary or power to be done in or
about the premises, as fully to all intents and purposes as I might or could
lawfully do if personally present, (with power of substitution and revocation),
and hereby ratifying and confirming all that my said attorney shall do or
cause to be done under and by virtue of these presents.
IN WITNESS WHEREOF, I have affixed my signature on this _____ day of
_______________, 20___ at __________________, Philippines.

_____________________________
_
Signature over Printed
Name

SPECIMEN SIGNATURE OF ATTORNEY-IN-FACT

_________________________
SIGNED IN THE PRESENCE OF:

_________________________

_________________________

ACKNOWLEGMENT
REPUBLIC OF THE PHILIPPINES
QUEZON CITY

)
) S.S.

BEFORE ME, on the place and date stated, personally appeared

______________________________, exhibiting to me her PASSPORT No.
____________________
issued
on
____________________
issued
at
___________________ known to me to be same person who executed the
foregoing special power of attorney and acknowledged the same to be his
personal act and deed.

NOTARY PUBLIC
DOC NO. _____
PAGE NO. _____
BOOK NO. _____
Series of 20___.